Skip to main content
SpringerLink
Log in

Adverse Reactions and Interactions with Newer Cephalosporin and Cephamycin Antibiotics

  • Adverse Drug Experience Review
  • Published:
Medical Toxicology Aims and scope Submit manuscript

Summary

In this review, adverse reactions and interactions associated with the use of the newer cephalosporins and cephamycins are surveyed; special emphasis is placed on those reactions specific for some of these newer agents, namely disulfiram-like reactions with alcohol, effects on prothrombin synthesis, and lower gastrointestinal tract reactions. It is apparent that cephalosporins with a 3-methylthiotetrazole side-chain in the cephem nucleus cause clinically significant side effects more frequently than those without such a moiety. While still having a high degree of safety, cephalosporins with this chemical structure clearly have a higher degree of toxicity than those without this side-chain.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Ackley Jr AM, Felsher J. Adverse reactions to cefaclor. Southern Medical Journal 74: 1550, 1981

    Article  PubMed  Google Scholar 

  • Adhinson NF, Swabb EA, Sugerman AA. Immunology of the monobactam aztreonam. Antimicrobial Agents and Chemotherapy 25: 93–97, 1984

    Article  Google Scholar 

  • Alestig K, Trollfors B, Andersson R, Olaison L, Suurküla M, Norrby R. Ceftazidime and renal function. Journal of Antimicrobial Chemotherapy 13: 177–181, 1984

    Article  PubMed  CAS  Google Scholar 

  • Angaran DM, Dias VC, Arom KV, Northrup WF, Kersten TE, et al. The influence of prophylactic antibiotics on the warfarin anticoagulation in the postoperative prosthetic cardiac valve patient. Cefamandole versus vancomycin. Annals of Surgery 199: 107–111, 1984

    Article  PubMed  CAS  Google Scholar 

  • Aronoff SC, Thomford W, Bertino JS, Speck WT. Development of meningitis during therapy with cefamandole. Pediatrics 67: 727–728, 1981

    PubMed  CAS  Google Scholar 

  • Aronsson B, Möllby R, Nord CE. Antimicrobial agents and Clostridium difficile in acute enteric disease: epidemiological data from Sweden 1980–1982. Journal of Infectious Diseases 151: 476–481, 1985

    Article  PubMed  CAS  Google Scholar 

  • Arvidsson A, Alvén G, Angelin B, Borgå O, Nord CE. Ceftriaxone: renal and biliary excretion and effect on the colon microflora. Journal of Antimicrobial Chemotherapy 10: 207–215, 1982

    Article  PubMed  CAS  Google Scholar 

  • Bang NU, Kammer RB. Hematologic complications associated with β-lactam antibiotics. Reviews of Infectious Diseases 5 (Suppl. 2): S380–S393, 1983

    Article  Google Scholar 

  • Bang NU, Tessler SS, Heidenreich RO, Marks CA, Mattier LE. Effects of moxalactam on blood coagulation and platelet function. Reviews of Infectious Diseases 4 (Suppl.): 546–554, 1982

    Article  CAS  Google Scholar 

  • Baumgartner JD, Glauser MP. Tolerance study of ceftriaxone compared to that of amoxycillin in patients with pneumonia. Proceedings of the 13th International Congress of Chemotherapy, Vienna, 1983

  • Betoni JM, Cho I. Severe myoclonus with moxalactam toxicity. Neurology 33 (Suppl. 2): 197–198, 1983

    Google Scholar 

  • Beuning MK, Wold JS, Israel KS, Kammer RB. Disulfiram-like reactions to β-lactams. Journal of the American Medical Association 245: 2027, 1981

    Google Scholar 

  • Brivet F, Dreyfus M, Bridey F, Naveau S, Sansonetti M, et al. Une nouvelle cause dávitaminose K aiguë: le lamoxactam. Gastroentérologie Clinique et Biologique 7: 937–938, 1983

    PubMed  CAS  Google Scholar 

  • Carlberg H, Alestig K, Nord CE, Trollfors B. Intestinal side effects of cefoperazone. Journal of Antimicrobial Chemotherapy 10: 483–487, 1982

    Article  PubMed  CAS  Google Scholar 

  • Chang JC. Acquired coagulopathy owing to parenteral cefamandole: renal failure as a predisposing factor. Annals of Clinical and Laboratory Science 13: 418–424, 1983

    PubMed  CAS  Google Scholar 

  • Chan-Lui WY, Stroebel AB, Yeung CY. Hemorrhagic tendency as a complication of moxalactam therapy in bacterial meningitis. Brain and Development 5: 417–420, 1983

    Article  PubMed  CAS  Google Scholar 

  • Childs SJ, Kosola JW. Update of safety of cefotaxime. Clinical Therapeutics 5 (Suppl. A): 97–111, 1982

    PubMed  Google Scholar 

  • Clancy CM, Glew RH. Hypoprothrombinaemia and bleeding associated with cephamandole. Lancet 1: 250, 1983

    Article  PubMed  CAS  Google Scholar 

  • Drummer S, Hauser Jr WE, Remington JS. Antabuse-like effect of β-lactam antibiotics. New England Journal of Medicine 303: 1417–1418, 1980.

    PubMed  CAS  Google Scholar 

  • Dudley MN, Quintiliani R, Nightingale CH. Review of cefonicid, a long-acting cephalosporin. Clinical Pharmacy 3: 23–32, 1984

    PubMed  CAS  Google Scholar 

  • Elenbass RM, Ryan JL, Robinson WA, Singsank MJ, Harvey MJ, et al. On the disulfiram-like activity of moxalactam. Clinical Pharmacology and Therapy 32: 347–355, 1982

    Article  Google Scholar 

  • Fainstein V, Bodey GP, McCredie KB, Kreating MJ, Estey EH, et al. Coagulation abnormalities induced by β-lactam antibiotics in cancer patients. Journal of Infectious Diseases 148: 745–750, 1983

    Article  PubMed  CAS  Google Scholar 

  • Fernex M, Havas L, Ryff JC, Clarke MR. Ergebnisse der klinischen Prüfung von Ceftriaxone. In Grieschaber (Ed.) Ceftriaxone (Rocephin) ein neues parenterales Cephalosporin. Proceedings of Hahnenklee Symposium, September 1981, pp.389–415, Editiones Roche, Basel, 1981

    Google Scholar 

  • Foord RD. Cephaloridine, cephalothin and the kidney. Journal of Antimicrobial Chemotherapy I (Suppl.): 119–133, 1975

    Article  Google Scholar 

  • Foster TS, Raehl DS, Wilson HD. Disulfiram-like reaction associated with a parenteral cephalosporin. American Journal of Hospital Pharmacy 37: 858–859, 1980

    PubMed  CAS  Google Scholar 

  • Fromtling RA, Gadebusch HH. Ethanol-cephalosporin antibiotic interactions: an animal model for detection of the disulfiram (Antabuse) like effects. Methods and Findings in Experimental and Clinical Pharmacology 5: 595–600, 1983

    PubMed  CAS  Google Scholar 

  • Gordon AJ, Phyfferoen M. Cefoperazone sodium in the treatment of serious bacterial infections in 2100 adults and children: multicentered trtals in Europe, Latin America and Australasia. Reviews of Infectious Diseases 5 (Suppl.): S188–S199, 1983

    Article  PubMed  Google Scholar 

  • Havas L, Fernex M, Kissling M. Literature survey on the clinical efficacy and tolerance of ceftriaxone: an analysis of 3,961 cases. Progress in therapy of bacterial infections. A new cephalosporin: ceftriaxone. Proceedings of a symposium, Bangkok, March 1983, pp. 130–145, Excerpta Medica, Amsterdam, 1983

    Google Scholar 

  • Homayouni H, Gross PA, Setia U, Lynch TJ. Leukopenia due to penicillin and cephalosporin homologues. Archives of Internal Medicine 139: 827–828, 1979

    Article  PubMed  CAS  Google Scholar 

  • Hooper CA, Haney BB, Stone HH. Gastrointestinal bleeding due to vitamin K deficiency in patients on parenteral cefamandole. Lancet 1: 39–40, 1980

    Article  PubMed  CAS  Google Scholar 

  • Idsöe O, Guthe T, Willcox RR, De Weck AL. Nature and extent of penicillin side-reactions with special reference to fatalities from anaphylactic shock. Bulletin of the World Health Organization 38: 159–188, 1968

    PubMed  Google Scholar 

  • Joehl RJ, Rasbach DA, Ballard JO, Weitekamp MR, Sattler FR. Moxalactam: evaluation of clinical bleeding in patients with abdominal infection. Archives of Surgery 118: 1259–1261, 1983

    Article  PubMed  CAS  Google Scholar 

  • Jolly ER, Henness DM, Richards Jr D. Human safety, tolerance and pharmacokinetic studies of cefadroxil, a new cephalo-sporin antibiotic for oral administration. Current Therapeutic Research 22: 727–736, 1977

    CAS  Google Scholar 

  • Kager L, Malmborg AS, Ljungdal I, Nord CE. Antibiotic prophylaxis with cefoxitin in colo-rectal surgery. Effect on the colon microflora and septic complications — a clinical model for prediction of the benefit and risk of using a new antibiotic in prophylaxis. Annals of Surgery 193: 277–282, 1981

    Article  PubMed  CAS  Google Scholar 

  • Kammer RB. Moxalactam: clinical summary of efficacy and safety. Reviews of Infectious Diseases 4 (Suppl.): S712–S719, 1982

    Article  PubMed  Google Scholar 

  • Kammer RB, Short LJ. Cefaclor — summary of clinical experience. Postgraduate Medical Journal 55 (Suppl. 4): 93–97, 1979

    PubMed  Google Scholar 

  • Kannangara DW, Smith B, Cohen K. Exfoliative dermatitis during cefoxitin therapy. Archives of Internal Medicine 142: 1031–1032, 1982

    Article  PubMed  CAS  Google Scholar 

  • Kaplan SL, Mason EO, Kvernland SJ, Loiselle EM, Feigin RD. Moxalactam treatment of serious infections primarily due to Haemophilus influenzae type b in children. Pediatrics 71: 187–191, 1983

    PubMed  CAS  Google Scholar 

  • Kirkwood CF, Smith LL, Rustagi PK, Schentag JJ. Neutropenia associated with β-lactam antibiotics. Clinical Pharmacy 2: 569–584, 1983

    PubMed  CAS  Google Scholar 

  • Kowalsky SF, Wishnoff FG. Evaluation of potential interaction of new cephalosporins with Clinitest. American Journal of Hospital Pharmacy 39: 1499–1501, 1982

    PubMed  CAS  Google Scholar 

  • Kroll MH, Elin RJ. Mechanism of cefoxitin and cephalothin interference with the Jaffé method for creatinine. Clinical Chemistry 29: 2044–2048, 1983

    PubMed  CAS  Google Scholar 

  • Lee AW, Proudfoot WH, Griffen Jr WO. Coagulopathy associated with broad spectrum antibiotic therapy. Journal of the Kentucky Medical Association 81: 367–369, 1984

    Google Scholar 

  • Lipsky, JJ, Lewis JC, Novick Jr WJ. Production of hypoprothrombinemia by moxalactam and l-methyl-5-thiotetrazole in rats. Antimicrobial Agents and Chemotherapy 25: 380–381, 1984

    Article  PubMed  CAS  Google Scholar 

  • Lovell SJ, Reid WD. Serum sickness with cefaclor. Canadian Medical Association Journal 126: 1032, 1982

    PubMed  CAS  Google Scholar 

  • Malmborg AS, Kager L, Nord CE. Effect of moxalactam on the bowel flora in patients undergoing colorectal surgery. (Abstract no. 27.) 23rd Interscience Conference on Antimicrobial Agents and Chemotherapy, Las Vegas, 1983

  • Mastella G, Agostini M, Barlocco G, Bunomi U, Borgo G, et al. Alternative treatment of pseudomonas infections in cystic fibrosis. Journal of Antimicrobial Chemotherapy 12 (Suppl. A): 297–311, 1983

    Article  PubMed  Google Scholar 

  • McMahon FG, Noveck RJ. Lack of disulfiram-like activity with ceftizoxime. Journal of Antimicrobial Chemotherapy 10 (Suppl. C): 129–133, 1982

    Article  PubMed  CAS  Google Scholar 

  • Moellering Jr RC. Enterococcal infections in patients treated with moxalactam. Reviews of Infectious Diseases 4 (Suppl.): S798–S711, 1982

    Article  Google Scholar 

  • Murray DL, Singer DA, Singer AB, Veldman JP. Cefaclor — a cluster of adverse reactions. New England Journal of Medicine 303: 1003, 1980

    PubMed  CAS  Google Scholar 

  • Nakamura K, Nakagawa A, Tanaka M. Effects of cephem antibiotics on ethanol metabolism. Folia Pharmacologica Japonica 83: 183–191, 1984

    Article  PubMed  CAS  Google Scholar 

  • Neu HS, Prince AS. Interaction between moxalactam and alcohol. Lancet 1: 1422, 1980

    Article  PubMed  CAS  Google Scholar 

  • Norrby R. Evaluation of adverse reactions to β-lactam antibiotics. Reviews of Infectious Diseases, in press, 1986a

    Google Scholar 

  • Norrby R. Side effects of cephalosporins. In Williams (Ed.) The Cephalosporin Antibiotics ADIS Press, Auckland, in press, 1986b

  • Norrby R, Alestig K. High frequency of gastro-intestinal adverse reactions to single doses of cefoperazone in healthy volunteers. Lancet 2: 1417, 1981

    Article  PubMed  CAS  Google Scholar 

  • Norrby SR, Burman LÅ, Linderholm H, Trollfors B. Ceftazidime: pharmacokinetics in patients and effects on the renal function. Journal of Antimicrobial Chemotherapy 10: 199–206, 1982

    Article  PubMed  CAS  Google Scholar 

  • Norrby R, Foord RD, Price JD, Hedlund O. Pharmacokinetics and clinical studies on cefuroxime. Proceedings of the Royal Society of Medicine 70 (Suppl. 9): 25–55, 1977

    PubMed  CAS  Google Scholar 

  • Norrby R, Martin CM, van Winzum C, Brown KR. The toxicity of cefoxitin in man. Journal of Infection 1 (Suppl. 1): 57–66, 1979

    Article  CAS  Google Scholar 

  • Oshawa T, Furukawa F. Neutropenia associated with cefotaxime. Drug Intelligence and Clinical Pharmacy 17: 739–741, 1983

    Google Scholar 

  • Pakter RL, Russell TR, Mielke CH, West D. Coagulopathy associated with the use of moxalactam. Journal of the American Medical Association 248: 1100, 1982

    Article  PubMed  CAS  Google Scholar 

  • Panwalker AP, Rosenfeld J. Hemorrhage, diarrhea, and superinfection associated with the use of moxalactam. Journal of Infectious Diseases 147: 171–172, 1983

    Article  PubMed  CAS  Google Scholar 

  • Parker SW, Baxter J, Beam Jr TR. Cefoperazone-induced coagulopathy. Lancet 1: 1016, 1984

    Article  PubMed  CAS  Google Scholar 

  • Petz LD. Immunologic cross-reactivity between penicillins and cephalosporins: a review. Journal of Infectious Diseases 137 (Suppl.): S74–S79, 1978

    Article  PubMed  Google Scholar 

  • Portier H, Chalopin JM, Freusz M, Tanter Y. Interactions between cephalosporins and alcohol. Lancet 2: 263, 1980

    Article  PubMed  CAS  Google Scholar 

  • Reddy J, Bailey RR. Vitamin K deficiency developing in patients with renal failure treated with cephalosporin antibiotics. New Zealand Medical Journal 92: 378–380, 1980

    PubMed  CAS  Google Scholar 

  • Reeves DS, Davies AJ. Antabuse effect with cephalosporins. Lancet 2: 540, 1980

    Article  PubMed  CAS  Google Scholar 

  • Rymer W, Greenlaw CW. Hypoprothrombinemia associated with cefamandole. Drug Intelligence and Clinical Pharmacy 14: 780–783, 1980

    Google Scholar 

  • Sanders CC, Sanders Jr WE, Goering RV. In vitro antagonism of beta-lactam antibiotics by cefoxitin. Antimicrobial Agents and Chemotherapy 21: 968, 1982

    Article  PubMed  CAS  Google Scholar 

  • Sanders Jr WE, Johnson JE, Taggart JG. Adverse reactions to cephalothin and cephapirin. Uniform occurrence on prolonged intravenous administration of high doses. New England Journal of Medicine 290: 424–429, 1974

    Article  PubMed  CAS  Google Scholar 

  • Saxon A. Immediate hypersensitivity reactions to β-lactam antibiotics. Reviews of Infectious Diseases 5 (Suppl. 2): S368–S379, 1983

    Article  Google Scholar 

  • Saxon A, Hassner A, Swabb EE, Wheeler B, Adhinson Jr NF. Lack of cross-reactivity between aztreonam, a monobactam antibiotic, and penicillin in penicillin allergic subjects. Journal of Infectious Diseases 149: 16–22, 1984

    Article  PubMed  CAS  Google Scholar 

  • Schmid L, Heit W, Flury R. Agranulocytosis associated with semisynthetic penicillins and cephalosporins. Blut 48: 11–18, 1984

    Article  PubMed  CAS  Google Scholar 

  • Schwigon CD, Barckom D. Blugerinnungsstörungen unter Cefoperazon und Lamoxactam. Diagnostik und Intensivtherapie 7: 221–225, 1982

    Google Scholar 

  • Shansky M, Greenlaw CW. Reversible acute leukopenia and cefoxitin. Annals of Internal Medicine 92: 874–875, 1980

    PubMed  CAS  Google Scholar 

  • Shimada J, Shimizu K. Experience with ceftizoxime: an overall summary of clinical trials in Japan. Journal of Antimicrobial Chemotherapy 10 (Suppl. C): 311–326, 1982

    PubMed  Google Scholar 

  • Smith CR. Cefotaxime and cephalosporin: adverse reactions in perspective. Reviews of Infectious Diseases 4 (Suppl.): S481–S488, 1982

    Article  PubMed  Google Scholar 

  • Smith JW, Johnson III JE, Cluff LE. Studies on the epidemiology of adverse drug reactions. II. An evaluation of penicillin allergy. New England Journal of Medicine 274: 998–1002, 1966

    Article  PubMed  CAS  Google Scholar 

  • Solley GO, Gleich GJ. Penicillin allergy: clinical experience with a battery of skin reagents. Journal of Allergy and Clinical Immunology 69: 238, 1982

    Article  PubMed  CAS  Google Scholar 

  • Tietze KJ, Gaska JA. Cefoxitin-associated exfoliative dermatitis. Clinical Pharmacy 2: 582–584, 1983

    PubMed  CAS  Google Scholar 

  • Tofte RW. Antibiotic-associated colitis during moxalactam therapy. Journal of Antimicrobial Chemotherapy 7: 445–446, 1981

    Article  PubMed  CAS  Google Scholar 

  • deTorres O. Hemolytic anemia and pancytopenia induced by cefoxitin. Drug Intelligence and Clinical Pharmacy 17: 816–818, 1983

    PubMed  CAS  Google Scholar 

  • Trollfors B, Norrby R, Bergmark J, Hultberg B, Linderholm H. Comparative toxicity of gentamicin and cefotetan. Scandinavian Journal of Infectious Diseases, in press, 1985

    Google Scholar 

  • Trollfors B, Norrby R, Kristiansson, K, Nilsson NJ. Effects on renal function of treatment with cefoxitin alone or in combination with furosemide. Scandinavian Journal of Infectious Diseases 13 (Suppl.): 73–77, 1978

    PubMed  Google Scholar 

  • Trollfors B, Suurküla M, Price JD, Norrby R. Renal function during cefuroxime treatment in patients with pre-existing renal impairment. Journal of Antimicrobial Chemotherapy 6: 665–670, 1980

    Article  PubMed  CAS  Google Scholar 

  • Warrington, RJ, Simmons FER, Ho HW, Gorski BA. Diagnosis of penicillin allergy by skin testing: the Mannitoba experience. Canadian Medical Association Journal 118: 787–791, 1978

    PubMed  CAS  Google Scholar 

  • Weitekamp MR, Aber RC. Prolonged bleeding time and bleeding diathesis associated with moxalactam administration. Journal of the American Medical Association 249: 69–71, 1983

    Article  PubMed  CAS  Google Scholar 

  • Wise R, Bennett SA, Dent J. The pharmacokinetics of orally absorbed cefuroxime compared with amoxycillin/clavulanic acid. Journal of Antimicrobial Chemotherapy 13: 603–610, 1984

    Article  PubMed  CAS  Google Scholar 

  • Young JPW, Husson JM, Bruch K, Blomer RJ, Savopoulos C. The evaluation of efficacy and safety of cefotaxime: a review of 2500 cases. Journal of Antimicrobial Chemotherapy 6 (Suppl. A): 293–300, 1980

    Article  PubMed  Google Scholar 

  • Yu VL. Enterococcal superinfections and colonization after therapy with moxalactam, a new broad spectrum antibiotic. Annals of Internal Medicine 94: 784–785, 1981

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Infectious Diseases, University of Umeå, Umeå, Sweden

    S. Ragnar Norrby

Authors
  1. S. Ragnar Norrby
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Norrby, S.R. Adverse Reactions and Interactions with Newer Cephalosporin and Cephamycin Antibiotics. Medical Toxicology 1, 32–46 (1986). https://doi.org/10.1007/BF03259826

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF03259826

Keywords

Search

Navigation